Fundamental Alteration Appeal

Please complete this form to notify the Chancellor that you’re appealing the decision of the Review Team regarding a requested accommodation. A copy will be sent to the Assistant Vice Chancellor for Student Affairs – Wellness and Inclusion.

Instructor name(Required)

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Instructor email(Required)

Instructor phone(Required)

Department(Required)

Semester (e.g. Spring 2020)(Required)

Course number (e.g. MUEN 4113(Required)

Course title (e.g. Concert Choir)(Required)

Please explain on what basis you're appealing the decision of the Review Team(Required)

Anything else you'd like the Chancellor to know about this situation?

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Fundamental Alteration Appeal

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